Will the city’s concerns go beyond being skin-deep?

There are those who call Mumbai Sin City, but when it comes to it, looks like Mumbai just does not have enough skin, even for its most needy.

After donating the skin of his late grandmother Ramdevi some months ago, Naresh Shamani is on a mission to reach out to as many people as possible and spread awareness about the cause. He says no feeling is more satisfying than knowing that someone has survived because of the skin he had donated.

Like Shamani, there are quite a few people who have donated the skin of their dead relatives to heal the wounds of burn victims. However such gestures are rare, and several victims die a slow and painful death because of non availability of skin, says Dr Shobha Chamania, president of the National Academy of Burns-India.

“Skin from donors is usually used for victims with more than 20-30% burns. For victims with less than 20% burns, their skin from the thigh region is taken and grafted in the required area,” says Dr Chamania.

Requirement for skin donation is pressing, as statistics clearly show (see pointers).

“Prime reasons for burns are dousing with fire, burns as a result of jilted lovers throwing acid, etc. Then there are accidental burns as a result of fire in kitchens or industrial units,” says Dr SM Keswani, of the National Burns Centre, Airoli.

Dr Chamania says that often victims are poor with no money for treatment. “And compounded with that is the dearth of skin from donors. Hence awareness about donation is crucial for saving lives.”

How does it work?
Experts say skin is usually harvested from the thigh and back of the cadaver. “Harvesting skin from the dead body does not result in any deformation, bleeding or exposure of organs as only a thin layer of the skin is taken,” says Dr Madhuri Gore, founder of the skin bank at Sion hospital.

The entire process takes less than an hour. Dr Gore says that skin is harvested in 6 hours of death, and if the body is in cold storage, then even 24 hours.

Social groups like Sunday Friends in Mumbai and Muskan Group in Indore go about harvesting skin by visiting the place of death within minutes of receiving a call, collecting the skin, and sending it to the banks at Sion hospital, and Choithram hospital & Research Centre respectively.

The National Burns Centre, which started a skin bank last year, also has professionals going about collecting skin.
Sandeepan Arya, Head of Department -eye/skin/body donation, Muskan Group, says if the dead person never objected, and if the relatives are willing, skin donation can be carried out.

Creating awareness
Doctors and social workers are spreading awareness on the need for skin donation, and dispelling myths associated.

Arya says during social functions like Holi, programmes etc. where thousands gather under one platform, Muskan goes about distributing pamphlets on skin donation, and gets counsellors to explain to people the nitty-gritty of the concept.

He adds that Muskan also attends the condolence meet of those whose skin has been donated, thanking the relatives for participating in the cause, and convincing others to partake in the activity.

Sunday Friends also goes about distributing cards printed with precise details of skin donation at condolence meets and social functions.

Professionals are engaging with first year college students and middle school students, on this issue too.

Dr Keswani says people working in this area talk to students of class 7-8, and educate them about the cause. “Class 7-8 is the right time to inform students as at that age they can understand and get convinced,” he adds.

Dr Gore says since starting the skin bank at Sion, she has been participating in seminars and radio talks to spread the word. She says that awareness needs to improve within hospitals, amongst doctors, so that when a person dies, doctors can suggest skin donation to the relatives. “Such suggestions within hospitals can get converted to donations,” says Dr Gore.

Donations are rising, but lag behind the requirement
Since 2000, when the first skin bank was set up in India, at Sion hospital, awareness is definitely on the rise, say experts, but still a lot needs to be done to meet the incessant requirements.

A Sunday Friends member says that from 2000-06, only 56 donations were received at Sion hospital. In 2007, the number shot up to 46. Dr Gore says in 2008 and last year, about 70-72 donations were received at Sion. “This year we plan to cross 100. So it is a good progress from 10 to 100 a year.”

The skin bank at Airoli gets an average of 3 donations per month, says Dr Keswani.
While Dr Chamania says that at the Choithram hospital, where she is director of the burns unit, since the bank was started a year ago, about 20 donations have been received till now.

Experts rue the fact that donations are never sufficient as the list of patients needing transplant is often never-ending.

“Almost immediately after the donation is made, the skin gets utilised,” says Dr Keswani.
The Sunday Friends member says that Sion hospital sees roughly 500 burns patients every year, of which about 350 are those requiring transplant. “So despite the rise, donations still lag behind the requirement.”